Individual provider Active NPI

Michael Young Han, MD

  • Urology Physician
  • Seattle, WA
National Provider Identifier
1063413144
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD60116158 Issued in WA
Practice address
1101 Madison St
#300
Seattle, WA 98104-1306
Phone
(206) 505-1800
NPI assigned
Aug 10, 2005
Last updated
May 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101237570 VA
Urology Physician 208800000X MD60116158 WA Primary

Addresses

Primary practice location

1101 Madison St
#300
Seattle, WA 98104-1306

Mailing address

1101 Madison St
#300
Seattle, WA 98104-1306
Phone (206) 505-1800

Other practice location 1

1909 214th St SE Ste 300
Bothell, WA 98021-4418
Phone (425) 412-7200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhan989182@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100118000064 WA Practitioner - Urology 7719922822 Reassigns benefits to 1 organization
I20190307002363 TX Practitioner - Urology 7719922822 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101237570VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics Current Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Feb 20, 2019 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Feb 20, 2019 Accepting new patients
Pacmed Clinics CurrentSince Jan 4, 2010 Accepting new patients
Pacmed Clinics CurrentSince Jan 4, 2010 Accepting new patients

Locations

37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

1909 214th St SE
Ste 300
Bothell, WA 98021
Phone (425) 412-6335

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1063413144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "#300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041306",
            "telephone_number": "206-505-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "#300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041306",
            "telephone_number": "206-505-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 214th St SE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980214418",
            "country_code": "US",
            "telephone_number": "425-412-7200",
            "fax_number": "425-412-7350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAN",
        "first_name": "MICHAEL",
        "middle_name": "YOUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101237570",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD60116158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhan989182@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1909 214th St SE Ste 300",
            "city": "Bothell",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980214418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.